Relation between osteocalcin and the energy metabolism in obesity

Background/Aim. Numerous findings have indicated the potential relation between the osteocalcin, the traditional parameter of bone turnover and the regulation of energy metabolism. The aim of this study was to identify the relationship between osteocalcin and calculated indexes, which evaluate insulin sensitivity, insulin resistance and/or secretory capacity of the pancreas, in non-diabetic, obese subjects. Methods. The study included 57 (11 men and 46 women) euglycemic, obese patients (the body mass index – BMI : 41.03 ± 6.61 kg/m²) and 48 healthy individuals, age and sex matched (BMI : 23.15 ± 2.04 kg/m²). Plasma glucose and the insulin levels during the two-hour oral glucose tolerance test (OGTT) were determined in order to calculate the Homeostatic Model Assessment (HOMA) indexes (HOMA-IR, HOMA-B%), EISI (estimated insulin sensitivity index), EFP (estimated first phase) and ESP (estimated second phase). Osteocalcin was measured by using the Electro-chemiluminescence (ECLIA) methodology. Results. Statistically lower osteocalcin was found in the obese subjects (24.72 ± 9.80 vs 33.31 ± 10.89 ng/mL; p < 0.01). Тhere was a statistically significant positive correlation between osteocalcin and EISI (r = 0.340; p < 0.01). The inverse correlations were found between the osteocalcin and HOMA-IR (r = -0.276; p < 0.01), HOMA-B% (r = -0.337; p < 0.01), EFP (r = -0.332; p < 0.01) and ESP (r = -0.266; p < 0.01). Multiple regression showed that the BMI and osteocalcin have a significant inverse prediction with the EISI and HOMA-IR, but the level of prediction of the BMI was substantially higher. Conclusion. The effect of osteocalcin in the glycoregulation is evident, but its contribution is significantly smaller in relation to other obesity associated factors. Therefore, when assessing its position and the role in glycemic control it is always necessary to bear in mind that osteocalcin represents only one of the many contributing factors, some of which exhibit dominant influence than osteocalcin itself

Dysfunctional ectopic thyroid gland: A case report

Introduction. Lingual thyroid gland is a rare anomaly of thyroid gland development, occurring more frequently in females. If it causes local symptomatology such as dysphagia, dysphonia or dyspnea it is diagnosed in childhood, however, if it is asymptomatic it is usually diagnosed in adulthood. Case Outline. We present a 23-year-old female patient in whom we diagnosed lingual thyroid gland coincidentally during diagnostic procedures of a concomitant disease. The application of 131I scintigraphy showed an oval field of intensive accumulation of radio markers in the zone of medial face line, around tongue base, with the absence of thyroid gland in its physiological position. Functional testing proved primary hypothyroidism and we started the application of substitution therapy. The application of levothyroxine resulted in reaching euthyroid state and the reduction of thyroid gland size. Conclusion. We present a very rare anomaly of the thyroid gland, and so far there have been no clear attitudes about further treatment. The general condition of the patient, age, the size of ectopic thyroid gland and the existence of local symptomatology or complications represent the factors that have influence on the choice of treatment method

The impact of currently used oral antihyperglycemic drugs on dysfunctional adipose tissue

Obesity is a disease with pandemic frequency, often accompanied by chronic metabolic and organic complications. Type 2 diabetes mellitus (T2DM) is among the most common metabolic complications of obesity. The first step in the treatment of T2DM is medical nutrition therapy combined with moderate physical activity and with advice to patients to reduce their body weight. Pharmacotherapy starts with metformin, and in the case of inadequate therapeutic response, another antihyperglycemic agent should be added. The most clinical experience exists with sulfonylurea agents, but their use is limited due to high incidence of hypoglycemia and increase in body weight. Based on the fact that dysfunction of adipose tissue can lead to the development of chronic degenerative complications, precise use of drugs with a favorable effect on the functionality of adipose tissue represents an imperative of modern T2DM treatment. Antihyperglycemic drugs of choice in obese individuals are those which cause maturation of adipocytes, improvement of secretion of protective adipokines, and redistribution of fat mass from visceral to subcutaneous depots. Oral antihyperglycemic agents that can affect the functionality of adipose tissue are metformin, SGLT-2 inhibitors, DPP-4 inhibitors, and thiazolidinediones